LEVEL OF PHYSICAL PREPAREDNESS OF STUDENTS OF THE BELARUSIAN STATE MEDICAL UNIVERSITY
Romanov K.U., Trofimenko A.M., Pereverzev V.A.
UDC: 796:613.71-057.875
Abstract: Objecive. To study the physical preparedness level of 1 year students of Belarusian State Medical University (BSMU) and possibilities of its adjustment by means of physical culture methods during a year of education. Methods. At the initial stage first year students (females) were tested according to the following indicators of physical fitness - “100 meters run”, “long jump”, “lifting the torso from the lying position on the back”, “500 meters run”. According to the obtained data an integral estimation of physical preparedness level of students at the beginning and at the end of the academic year was carried out. At the second stage physical fitness methodology was integrated in physical culture educational discipline. The methodology was aimed at increasing the physical preparedness level; the evaluation of its effectiveness was made by the assessment of the above-mentioned physical fitness data dynamics. Results. The study of the indexes of physical preparedness of 1 year students carried out during 6 years revealed low levels of endurance development and speed development. The adoption of physical fitness methodology in educational process led to considerable and reliable improvement of all the indexes studied. Thus, the indexes of 100 meters run and 500 meters run were shortened by 4.6% (P<0.05), and 9.3% (P<0.001); the number of lifting the torso increased by 18% (P<0.001); the augmentation of the length in the long jump test was 6.4% (P<0.05). Conclusion. The obtained data indicate the necessity of priority health-improving orientation of students’ physical education, through the use of health technologies optimizing the function or the condition of the students’ body.
Key words: студенты, физическая подготовленность, бег, прыжки, подтягивание, интегральная оценка, students, physical preparedness, running, jumping, lifting the torso, integral estimatnion
COMPARATIVE CHARACTERISTIC OF FAILURES AVOIDANCE MOTIVATION AND STRATEGY OF BEHAVIOR IN STRESSFUL SITUATIONS OF MEDICAL AND PEDAGOGICAL HIGHER EDUCATION INSTITUTIONS STUDENTS
Udalova T.Yu., Mordyk A.B., Ivanova O.G., Puzyreva L.B., Nikiforova Yu. S., Shikeneva E.S.
UDC: 159.9.072.42
Abstract: Objective. To identify the features of failures avoidance motivation and the strategy of behavior in crisis situations in medical and educational psychology students. Methods. 68 students of the medical university and 103 students of the pedagogical university studying educational psychology participated in a research. The age of the respondents was 19-22 years. The following tests were used: "Motivation to an avoidance of failures" (T. Elers) and "The strategy of overcoming stressful situations" (SACS) S. Hobfoll (the Russian-language version of N. Vodopyanova, E. Starchenkova). A verification of the hypothesis of normal distribution of values in groups was carried out on asymmetry in the Statistica 6 program. Results. The analysis of the results of the test questionnaire "Motivation to an avoidance of failures" revealed an average level of avoidance of failures in the group of future doctors, while in the group of future educational psychologists it was above the average. Most future educational psychologists have a high level of protection and a fear of accidents while it is lower in medical studens. The analysis of the "The strategy of overcoming stressful situations" technique in future educational psychologists and techers revealed the prevalence of both active and pro-social "healthy" coping strategies. However, medical students do not always choose adequate models of the overcoming behavior. Future educational psychologists have no obvious preferences in the choice of the strategy of overcoming and are more focused on the situation. Conclusion. Students mostly choose to search for social support as a strategy of the overcoming behavior, asocial actions are least expressed. However, statistically significant avoidance is more often revealed in future doctors.
Key words: студенты, будущие педагоги-психологи, будущие врачи, мотивация к избеганию неудач, стрессовые ситуации, стратегии преодоления стрессовых ситуаций, students, future educational psychologists, future doctors, failures avoidance motivation, stressful situations, strategy of overcoming stressful situations
CORRELATION BETWEEN DENTAL SOLID TISSUES CARIES RESISTANCE AND IODINE-CONTAINING THYROID HORMONES
Gorodetskaya I.V., Masiuk N.Y.
UDC: 577.175.44:[616.314-002:616.316-008.8]
Abstract: Objective. To establish the effect of the thyroid status on the resistance of dental solid tissues to caries and reveal its mechanisms. Methods. In the study the thyroid status was modulated by a mercazolilum injection (25 mg/kg 30 days, half-dose till the 60 day), or L-thyroxine (1.5-3.0 mcg/kg 28 days, 1.5 mcg/kg till the 60 day). The cariogenic diet of choice was the high carbohydrate Stephan diet. Stress was simulated by the crowd keeping of animals within 60 days. The intensity of the caries process was assessed by the prevalence, frequency, severity and depth of the lesion. The enamel density was evaluated radiographically, the level of calcium in the saliva - by the method of complexometric titration. The data were processed using the program «STATISTICA 6.0». Results. Stress per se leads to less expressed carious processes than in case of the Stefan diet, but it potentiates its cariogenic action. Hypothyroidism increases, physiological doses of L-thyroxine, on the contrary, suppress the susceptibility of the enamel to caries in rats receiving the cariogenic diet, in stress, or in combinations. Conclusion. The stimulation of the resistance of dental solid tissues to caries by iodine-containing thyroid hormones is based on the increase of the enamel density and the concentration of calcium in the saliva.
Key words: йодсодержащие гормоны щитовидной железы, кариес, стресс, слюна, кальций, iodine-containing thyroid hormones, caries, stress, saliva, calcium
PECULIARITIES OF LIPID METABOLISM, HYPOPHYSIAL AND THYROID FUNCTIONS IN CHILDREN WITH ARTERIAL HYPOTENSION
Sycorsky A.V., Pereverzev V.A., Novikova L.V.
UDC: [616.12-008.331:612.015.3]-053.2
Abstract: Objective. To study lipid metabolism characteristics, hypophysial and thyroid functions in school -aged children with arterial hypotension. Methods. 416 school age children with arterial hypotension were examined. There were three groups among them: 113 children with essential arterial hypotension (EAH), 111 children with symptomatic arterial hypotension (SAH) developed against the background of chronic gastroduodenal pathology; 104 children with chronic pathology of the gastroduodenal area and without arterial hypotension (the Experimental Condition group); 88 healthy children of the comparable sex and age. The lipidogramm data were measured by biochemical analyzer and commercial set RANDOX; the atherogenesis coefficient (AC) was calculated. The content of pituitary body hormones and thyroid gland hormones was determined by immunoradioassay. Results. In children with EAH disorders of the apolipoproteins synthesis were revealed; it was combined with the reduction of the levels of free and bound thyroxin. The above-mentioned metabolic disorders led to the dysfunction of the cholesterol transport system with the prevalence of cholesterol transport to tissues and impairment of its removal into the liver and excretion. In children suffering from SAH, thyroid gland dysfunction with the loss of free and bound thyroxin levels developed on the basis of chronic gastroduodenal area pathology; dyslipidemia with the prevalence of the atherogenic cholesterol fractions was also revealed. Symptomatic arterial hypotension (SAH) was associated with more evident impairment of thyroid gland function and lipid metabolism in comparison with isolated variants of chronic gastroduodenal pathology in school age patients. Conclusion. Thus, children with any form of arterial hypotension (EAH, SAH) have identical disorders of lipid metabolism and thyroid function; it promotes early atherosclerotic process in the chosen group of patients.
Key words: дети, артериальная гипотензия, обмен липидов, гормоны, гипофиз, щитовидная железа, children, arterial hypotension, lipid metabolism, hormones, hypophysis, thyroid gland
PREVENTION OF PROSTHETIC STOMATITIS CAUSED BY FUNGI OF THE GENUS CANDIDA
Shashmurina V.P., Fedoseev A.V., Kiryushenkova S.V., Nikolaev A.I., Solomanova N.D., Fedoseev V.A.
UDC: 616.314-089.28
Abstract: Objective. To investigate the colonization of dentures with Candida depending on the type of prosthesis and location on the mandible or maxilla; determination of antifungial activity effectiveness of 0.25% and 1% solutions of antiseptic preparation "Optimaks" in combination with or without ultrasound against the Candida fungi in disinfection of dentures with acrylic basis. Methods. The removable dentures used by 66 patients in Smolensk dental clinic N3 were the object of the investigation. There were 8 men and 58 women including 36 patients with removable dentures of the upper jaw, 30 with dentures of the low jaw. The average age of the patients was 45-60 years. Prosthesis with used for 6 months to 3 years were included in the study. Results. It was found that C. Albicans spp. were detected on the prosthesis base with high frequency (54.57%±0.78%). Microbiological studies showed that application of 0.25% and 1% solutions of "Optimaks" in combination with ultrasound and without it for disinfection of dentures had an expressed antifungial activity. The problem of removable dentures disinfection is relevant because they can be a source of infection for patients, dentists and dental technicians. Conclusion. The results of the study allow to recommend these methods for the use in dental clinics and dental laboratories and for individual care of patients for dentures.
Key words: съёмные зубные протезы, стоматит, дезинфекция зубных протезов, грибы рода Candida, removable dental prosthesis, stomatitis, disinfection dental prosthesis, genus Candida
AWAKE CRANIOTOMY WITHOUT SEDATION IN TREATMENT OF SYMPTOMATIC EPILEPSY
Sitnikov A.R., Grigoryan Yu.A., Maslova N.N., Mishnyakova L.P., Manevsky A.A.
UDC: 616.853-089
Abstract: Objective. To show the advantages of awake craniotomy without sedation, accompanied by intra-operative neurophysiological monitoring in patients with symptomatic epilepsy. This article describes the results of surgical treatment in 41 patients with various pathology, 31 among them suffered from epilepsy. Methods. 41 patients (26 males and 16 females) aged from 19 to 74 years underwent awake-awake-awake craniotomy with neurophysiological monitoring from 2009 to 2016. Pre-operative evaluation along with clinical investigation included 1.5 or 3 Tesla MRI to visualize the location and extent of pathological foci, fMRI and DTI-tractography to estimate the relationship between the pathological area and cortical eloquent zones and subcortical tracts. In all cases, long-term EEG-video-recording was performed before and after surgery to locate an epileptogenic zone. Results. Most frequently, the pathological foci were located in the frontal and parietal lobes nearby eloquent brain areas. Irrespective of damage location, the simple partial and complex partial seizures were revealed almost with the same frequency. Intra-operative mapping of eloquent cortical areas and subcortical tracts without sedation resulted in total resection of the pathological area in 75% of cases with low rate of permanent neurological deficit (2 patients). Minor perioperative complication, including the dropping of blood pressure in 6 patients and intra-operative convulsions in 2 patients were handled and didn’t lead to operation abortion or anesthesia conversion. Excellent seizures control (Engel 1) was achieved in 80% of patients with available catamnesis. Conclusion. Thus, the proposed method allows to eliminate the complications associated with sedation and provides the radical resection of pathological epileptogenic foci with low complication rate.
Key words: эпилепсия, краниотомия в сознании, нейрофизиологический мониторинг, картирование мозга, epilepsy, awake craniotomy, neurophysiological monitoring, brain mapping
DIASTOLIC DYSFUNCTION OF THE RIGHT HEART AND PULMONARY HYPERTENSION AT THE OVERLAP - PHENOTYPE (THE COMBINATION OF BRONCHIAL ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE) ACCORDING TO THE REGISTER OF BRONCHIAL ASTHMA OF KURSK REGION
Pribylov S.A., Samosudova L.V., Pribylova N.N., Shabanov E.A.
UDC: 616.123+616.248+616.24-007.272-036.12
Abstract: Objective. The purpose of this study was to evaluate the indicators that characterize the diastolic function of the heart and the severity of pulmonary hypertension in a cross phenotype - a combination of bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD), depending on the level of disease control and the presence of exacerbation. Methods. To achieve these goals, we used the technique of analyzing outpatient charts of patients with a cross phenotype (BA + COPD) according to the register of the Kursk region with ultrasound examination of the heart when the patients were referred for medical help to the health facility for exacerbation of diseases or loss of control over asthma. Results. The patients suffering from BA and COPD had a change of the geometry of the right heart. Diastolic dysfunction of the right heart is more expressed in a combination of BA and COPD and is one of the precursory symptoms of a myocardial lesion of the right heart. That is evident in depression of the rate of blood peak flow during early filling of the right heart (E), increase of the rate of blood peak flow during late filling (A) and depression of the E/A ratio of theright heart (р<0.001). The incidence of inadequate diastolic function is significant (χ²=4.22; p3<0.03) compared with the control group. Pulmonary hypertension was stated in 90% of cases at a combination of BA and COPD. The lack of control BA in case of overlap-phenotype is followed by a higher increase of systolic pressure in the pulmonary artery, increase of the transversal size of the right ventricle, and also more expressed disturbance of patency of small airways versus controlled BA accompanying COPD. Conclusion. During the study it was established that diastolic dysfunction of the prostate is most pronounced in combination with AD and COPD and is one of the early signs of myocardial damage to the prostate. The uncontrolled clinical course of asthma in the presence of concomitant COPD leads to more severe pulmonary hypertension and an increase of the right ventricle.
Key words: бронхиальная астма, ХОБЛ, перекрестный синдром, диастолическая дисфункция правого желудочка, легочная гипертензия, bronchial asthma, COPD, overlap-syndrome, diastolic dysfunction of the right ventricle, pulmonary hypertension
INFLUENCE OF THE GENDER ON THE REASONS OF LETHAL OUTCOMES IN THE ANTITUBERCULOUS CLINIC
Puzyreva L.V., Mordyk A.V., Shlychkova N.V., Brjuhanova N.S., Zhigalova L.A., Hlebova N.V.
UDC: 616.98:616.084:616-053.1
Key words: tuberculosis, HIV infection, coinfection, gender accessory, lethal outcome, generalized tuberculosis
DYNAMICS IN THE IN-PATIENT ACTIVITIES OF THE DEPARTMENT OF CLINICAL IMMUNOLOGY AND RHEUMATOLOGY OF THE RUSSIAN CHILDREN’S CLINIC UNDER THE MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION IN 2012-2016
Teshchenkov A.V., Shumilov P.V.
UDC: 616.72-002.77-053.2
Abstract: Objective. The aim of the study was to investigate the dynamics in hospitalization rates in children and adolescents with juvenile rheumatoid arthritis (JRA) at the Department of Clinical Immunology and Rheumatology of the Russian National Children’s Clinic under the Ministry of Health of the Russian Federation in 2012-2016, taking into account their age, gender, clinical forms of the disease and residence. Methods. Medical documentation was analyzed and involved annual activity reports of the Department, case histories of patients with JRA (format 112Х, as well as the medical histories of all children and adolescents with JRA who were hospitalized in 2012-2016 and treated at the Department of Clinical Immunology and Rheumatology of the Russian National Children’s Clinic under the Ministry of Health of the Russian Federation. Statistical analysis to compare the number of hospitalizations was made. Quantitative data as well as JRA patients’ age and gender were analyzed. Clinical forms of the disease were also taken into consideration. Regions of residence of JRA hospitalized patients were analyzed as well. In addition, a method of continuous sampling was applied in 107 patients hospitalized in 2016; the analysis involved quantitative characteristics, patients’ age, gender, taking into account the forms of the disease and the course of the rheumatoid arthritis as well as patients’ residence. Results. Significant decrease in the number of hospitalized patients with JRA in the Department and a change in the ratio of different clinical forms of the disease in hospitalized patients were noted. The reduction in the number of the articular-visceral and articular forms was revealed as well. The incidence of JRA children and adolescents in Russia is not reduced, which characterizes the improvement of the clinical diagnostic process and therapeutic tactics with JRA in regions of the Russian Federation. The number of hospitalized children and adolescents with JRA in the age aspect is keeping the same. The majority of patients are aged 7 and older. The ratio of hospitalized patients is changing and demonstrates a decrease in the number of hospitalized patients who come from various regions of the Russian Federation and an increase in the number of hospitalized patients from Moscow and the Moscow region. Conclusions. The study reflects the quality of care for children and adolescents with JRA both at the Department of Clinical Immunology and Rheumatology the Russian National Children’s Clinic under the Ministry of Health of the Russian Federation in from 2012-2016 and other Russian regions. The improvement is due to better diagnostics and treatment of JRA patients both in the Central Hospital of the country and in out-patient departments of regions of the Russian Federation.
Key words: дети и подростки, ювенильный ревматоидный артрит, иммунология, ревматология, children, adolescents, juvenile rheumatoid arthritis, immunology, rheumatology
METABOLIC SYNDROME AND MALE REPRODUCTIVE HEALTH: THE FORMATION OF A HEALTHY LIFESTYLE AS A LEADING METHOD FOR PROPHYLAXIS OF INFERTILITY
Poliakova M.V.
UDC: 612.61+612.663
Abstract: Objective. To identify and study the prevalence of the independent medico-social predictors of excess body weight in young adults males and their role in the development of obesity - one of the risk factors of male infertility. Methods. The study included two groups of men. The observation group consisted of 14 men aged 19 to 24 years with overweight, body mass index (BMI) ≥25 kg/m; the control group - of 24 men aged 19 to 24 years without overweight and obesity, BMI≤24.9 kg/m. All participants were investigated for family history, lifestyle and nutrition, physical activity level; anthropometric measurements (body weight, height, BMI, waist circumference). Their awareness about the influence of various agents on the male reproductive health status was estimated. Results. The study revealed that the following main reasons for the development of obesity regardless of age: incorrect diet (high-calorie, irregular) and hypodynamia. The disease often runs in families. Conclusion. Modification of lifestyle by diet change and increase of physical activity does not only decrease the body weight but also reduces potential reproductive system pathologies.
Key words: ИМТ, ожирение, метаболический синдром, мужской репродуктивный потенциал, факторы риска, гиподинамия, BMI, obesity, metabolic syndrome, male reproductive potential, risk factors, hypodynamia
FACTORS AFFECTING THE STIFFNESS OF THE RENAL PARENCHYMA ACCORDING TO ELASTOGRAPHY SHEAR WAVE IN CHILDREN WITH SIMPLE OBESITY
Kozlova E.Yu., Bekezin V.V., Borsukov A.V., Peresetskaya O.V., Druzhinina T.V., Pleskachevskaya T.A.
UDC: 616.61-073.48-053.2
Abstract: Objective. To determine the influence of clinical and metabolic criteria on the stiffness of the renal parenchyma (elastography shear wave) in children with obesity. Methods. 63 children, adolescence (11 to 17 years) with obesity were examined. The 1st group included 26 children with simple uncomplicated obesity. The second (main) group consisted of 37 children with metabolic syndrome in accordance with the criteria of the International diabetes Federation (IDF, 2007). Children of the 1st and 2nd groups did not receive drug therapy. The aim of the study was to assess the influence of individual clinical and metabolic criteria according to the results of multiple correlation analysis of stiffness of the renal parenchyma with elastography shear wave in children with obesity. We conducted biochemical blood analysis with the definition of the parameters of lipid and carbohydrate metabolism, determination of renal function in a sample of general, glomerular filtration rate calculated using the formula of Schwarz, oral glucose tolerance test, determination of microalbuminuria (test system Mikroalbuphan). Daily blood pressure monitoring was performed with the PLAB apparatus (Russia). Elastography shear wave was conducted by digital portable ultrasound system ANGIODIN-sono/P-Ultra (NPF "BIOSS", Russia) electronic convex probe of 3-6 MHz. Results. The median elasticity of the parenchyma of the right kidney in children with metabolic syndrome and children with uncomplicated simple obesity were higher than in children of the control group by 4.3 and 2.1 times, respectively. In children of the 2nd group, the elasticity of the renal parenchyma had significantly (p<0.05) higher rates than in children with uncomplicated obesity. In children with uncomplicated obesity (group 1) increase in the anthropometric indicators (body weight, body mass index), as well as an increase in blood pressure according to the results of daily profile are associated with increased density of the renal parenchyma according to elastography shear wave. In children with metabolic syndrome (group 2) the following factors lead to an increase of the density of the renal parenchyma according to elastography shear wave: anthropometric (increase of body mass index and waist circumference); clinical (hypertension (labile, stable); laboratory (increase in triglycerides, low-density lipoproteins); additional factors (high microalbuminuria). The factor of atherogenic dyslipidemia on the background of abdominal obesity affects the condition of rigidity of the renal parenchyma in children of the 2nd group in contrast to children of the 1st group. Conclusion. Risk factors increase the rigidity of the renal parenchyma according to elastography shear wave, thus leading to the formation of chronic kidney disease. In adolescent children with simple obesity, the risk factors are abdominal obesity, atherogenic dyslipidemia, hypertension and microalbuminuria.
Key words: дети, ожирение, эластография, хроническая болезнь почек, children, obesity, transient elastography, chronic kidney disease
ETIOLOGICAL STRUCTURE OF HOSPITAL-ACQUIRED SURGICAL INFECTIONS IN MULTI-PROFILE HOSPITALS IN RUSSIAN FEDERATION
Kuz'menkov A.Yu.
UDC: 616.9-022.36
Abstract: Objective. To analyze the etiological structure of hospital-acquired surgical infections in multi-profile hospitals in the Russian Federation. Methods. The article is based on the data collected in the prospective multicenter epidemiological studies of antibiotic resistance for the time period from 1997 to 2015 years. A total of 5118 patients with the established fact of the presence of hospital-acquired surgical infection were included in the current study from 37 cities of the Russian Federation.Results. The article reflects age-sex distribution of the studied group of patients, etiological structure and its change over time in different Federal districts in the Russian Federation. Among the examined patients, there were 61.77% of male and 38.23% of female. Age characteristics, depending on sex, were the following: the median age of males was 48 (34; 59) years, the median age of females was 53 (39; 67) years. In the etiological structure of hospital-acquired surgical infection, the number of bacteria from the "ESCAPE" group ( E. faecium, S. aureus, K. pneumoniae, A. baumannii, P. aeruginosa and Enterobacter spp.) was 73.56%. It should be noted that the etiological structure of hospital-acquired surgical infection, despite minor fluctuations, did not change significantly over time and it was similar between the federal districts. Nevertheless, there was variability of frequency of identification of S. aureus , with the maximum frequencies observed in the Central and Volga federal districts. However, S. aureus was the first in frequency of identification, despite the geographical location of the hospital. Conclusion. Based on our results, we concluded that S. aureus (34.98%), P. aeruginosa (19.63%), E. coli (9.80%), A. baumannii (9.29%), K. pneumoniae (7.48%) are the most common pathogens in the etiological structure of hospital-acquired surgical infections.
Key words: хирургические инфекции, нозокомиальные инфекции, этиологическая структура инфекций, surgical infections, hospital-acquired infections, etiological structure of infections
MECHANISMS OF THE INCREASE OF THE STRUCTURAL AND FUNCTIONAL STABILITY OF DENTAL SOLID TISSUES BY IODINE-CONTAINING THYROID HORMONES
Gorodetskaya I.V., Masiuk N.Y.
UDC: 577.175.44:[612.311.1:612.313.6]
Abstract: Objective. To study the effect of iodine-containing thyroid hormones on the formation of structural and functional resistance of the enamel to cariogenic influences. Methods. Mercazolilum was injected at a dose of 25 mg/kg for 30 days, then at half-dose till the 60 day), L-thyroxine in small doses (1.5-3.0 mcg/kg for 28 days, then at a dose of 1.5 mcg/kg till 60 day). The cariogenic influences were the diet of Stephan (within 60 days), crowding-stress (40 animals in a cage in the 1 month, 30 ones in the 2 month), and their combination. The resistance of dental solid tissues was evaluated by the test of resistance of the enamel, the remineralizing strength of the saliva - by its microcrystallisation and mineralizing potential; the activity of lipid peroxidation in the saliva - by the chemiluminescence method. The data were processed statistically with the help of the nonparametric methods (Statistica 6.0). Results. Mercazolilum decreases while small doses of L-thyroxine increase the resistance of enamel to all the applied cariogenic influences due to the action to the intensity of lipid peroxidation and remineralizing properties of the saliva. Conclusion. The antioxidant and the normalizing mineralizing potential of the saliva mechanisms of the increase of the resistance of dental solid tissues was established.
Key words: йодсодержащие тиреоидные гормоны, стресс, резистентность эмали, перекисное окисление липидов, слюна, iodine-containing thyroid hormones, stress, resistance of the enamel, lipid peroxidation, saliva
FREQUENCY OF SEVERE STAGES OF RETINOPATHY OF PREMATURITY IN COMPARICON WITH GESTATIONAL AGE AND WEIGHT AT BIRTH AT PRETERM NEWBORNS IN SMOLENSK REGION
Deev L.A., Solovyeva E.S.
UDC: 17.735-002-053.32
Abstract: Objective. To study the frequency of severe stages of retinopathy of prematurity in comparison with gestational age (GA) and weight at birth (BW) at preterm newborns in Smolensk region. Methods. 184 preterm newborns with retinopathy of prematurity (ROP) were included in to the group and retrospectively studied. Frequency of severe stages of retinopathy of prematurity in comparison with GA and BW was stated. All newborns were divided into two groups according to clinical course of ROP. 153 newborns with early stages (stages I and II) with an average GA of (29±0.2) weeks and with an average BW (1200±30.0) grams entered the 1-st group. 31 newborns with stage III and aggressive posterior ROP with an average GA of (27±0.4) weeks and with an average BW (900±46.0) grams were taken in to the second group. To state the newborns from the group of high risk of unfavorable course of the disease threshold meanings were taken. In both groups it was performed the categorization in respect of indicators of GA and BW for subthreshold and after it. Results. The incidence of severe rapidly progressing forms of ROP made up 4.3% among newborns at risk and 16.8% among all affected newborns. The threshold meaning for gestational age was defined 26 weeks and threshold meaning for weight was determined as 970 grams. Categorized samples statistically differ from each other in threshold meaning weight at birth. Conclusion. The frequency of severe stages of ROP at preterm newborns in Smolensk region is comparable with the average data in Russia. Selected threshold meaning of indicators of GA and BW help state a high-risk group of severe form of ROP and can be used in practice to assess the quality of the care of premature infants.
Key words: ретинопатия недоношенных, масса тела, гестационный возраст, пороговое значение, retinopathy of prematurity, severe stages, weight at birth, gestational age, threshold meaning
CLINICAL CASE OF RARE LEIOMYOMA
Pribytkin A.A., Denisova N.S., Narezkin D.V., Sergeev A.V.
UDC: 616.349
Abstract: Objective. To study the possibility of removal of rare localization leiomyom by using video laparoscopic techniques on the example of the clinical observation. Methods. Patients with a verified diagnosis of "leiomyoma" are subject to surgical treatment, which is dictated by the danger of various complications. Various variants of interventions are performed: enucleation, resection of the esophagus, stomach, small or large intestine. In recent years, widespread removal of leiomyomas of different locations using laparoscopic techniques has been registered. Results. When diagnostic laparoscopy was performed, a mobile tumor-like formation of pale yellow color (46×38 mm), on a long pedicle, originating from the sigmoid colon wall at its middle 1/3 in the protruded scape was identified. The formation was removed. The histological conclusion was leiomyoma. Conclusion. Retrospectively examining the clinical manifestations of the disease, we can assume that the recurring pain syndrome was apparently due to the mobility of the formation. Torsion of the tumor on the pedicule resulted in disturbance of blood supply, which in turn was accompanied by the appearance and strengthening of the pain syndrome in the lower abdominal cavity.
Key words: лейомиома, гладкомышечная опухоль, лапароскопия, leyomyoma, smooth muscle tumor, laparoscopy
POLYMORPHISM OF CLINICAL AND PSYCHOLOGICAL MANIFESTATIONS OF TRAUMATIC EXPERIENCES IN ADOLESCENTS IN CONDITIONS OF DEPRIVATION EXPERIENCE
Ulasen T.V., Vaulin S.V.
UDC: 616.89:362.73
Abstract: Objective. To carry out an analysis of clinical and socio-psychological manifestations of traumatic experiences of inmates of local institutions for the formation of a differentiated approach of medico-psychological support for this contingent. Methods. The semi-structured interview (PUPSD), developed by A.I. Depenau and A.V. Makarchuk (2004)To was used to identify the signs of post-traumatic stress (PTSD) in adolescents; and the improved Toronto alexithymia scale (Toronto Alexithymia Scale, or TAS-20) was apllied to quantify alexithymia. Results. There was a statistically significant predominance of the level of severity of the clinical manifestations of criterion A (immediate response) in adolescents of group I (orphans and social orphans) compared with adolescents in group II, which had no correlation with other criteria of PTSD according to the DSM-IV. Adolescents living in families (group 2), in contrast, revealed the deletion of criterion F (faults) out of the picture of clinical and socio-psychological criteria of PTSD. An analysis of the severity of alexithymia manifestations (total score, difficulties in identifying feelings, difficulty describing feelings to others) revealed a tendency to the prevalence of high levels on each feature in the studied inmates of local institutions. A moderately expressed negative relationship between the level of external thinking and total score of alexithymia in adolescents living in families was noted indicating a decrease in the subjective control, and weakening of the predictive reactions in response to stressful situation occuring with a general decrease in alexithymic manifestations Conclusion. The conclusion about the presence of different clinical and psychological manifestations of traumatic experiences of inmates of local institutions, requiring a differentiated approach to the choice of an individual plan of rehabilitation measures, depending on the belonging to the I group (orphans and social orphans) and group II (adolescents brought up in families) was made.
Key words: посттравматические переживания, совладающее поведение, алекситимия, воспитанники социозащитного учреждения, posttraumatic experiences, coping behavior, alexithymia, pupils of a socioprotective institution
REVIEW OF THEORETICAL CONCEPTS OF SUICIDAL BEHAVIOR FROM THE POSITION OF GERIATRIC PSYCHIATRY
Reshedko L.A., Vaulin S.V., Alexeeva M.V.
UDC: 616.89
Abstract: Objective. To analyse the main theoretical concepts of suicidal behavior, taking into account the specificity of the age factor, namely the gerontological aspect, to identify the tasks of gerontological suicidal care at the present stage. To identify the main factors influencing the occurrence of suicidal behavior and suicidogenesis in old age, to give an integrative assessment of suicidal risk in gerontopsychiatry, to analyze the mutual influence of these factors in the elderly from the position of the main theoretical concepts of suicidal behavior. Methods. For this research, various domestic and foreign literature on the relevant topic was collected and analyzed. Results. The study revealed the main theoretical preconditions for the formation of suicidal behavior in the elderly. The specificity of socio-psychological factors in the genesis of suicidal behavior in gerontology is presented, the account of which will help specialists to identify the risk of occurrence and relapse of suicidal behavior. The biological factors in the development of autoaggressive behavior in old age are evaluated. The role of hereditary complication in mental illnesses is shown as a significant risk factor for the occurrence of a suicidal process; some genetic factors of suicidogenesis are described. Conclusion. The results of the study will help specialists of the appropriate profile in diagnosing, assessing the suicidological status of the patient, as well as predicting and preventing suicidal manifestations in the future. The interrelation of suicidal manifestations with different psychiatric pathologies of the old age is demonstrated, the most suicidal dangerous mental illnesses of the old age are identified. The role of a combination of various factors in the formation of suicidal behavior in the elderly is shown. The presented data will allow specialists to improve the quality of psychiatric care for elderly people whose mental illnesses are accompanied by suicidal thoughts and suicide attempts.
Key words: суицидальное поведение, пациенты пожилого возраста, теоретические концепции суицидального поведения, мультифакторный подход к изучению суицидального поведения, suicidal behavior, elderly patients, theoretical concepts of suicidal behavior, a multifactorial approach to the study of suicidal behavior
CHARACTERISTICS OF PREFERENTIAL DRUG PROVISION IN SMOLENSK REGION
Lopashinov P.M., Nevinitsyn E.L., Narkevich I.A., Kisileva A.N., Krikova A.V., Evseev A.V.
UDC: 614.2
Abstract: Objective. To study the peculiarities of drug provision in Smolensk region. Methods. Analytical, logical and theoretical method as well as content analysis of reference literature were applied. The analysis of the items of drugs of different pharmacological groups registered and allowed for circulation in the Russian Federation was performed. Results. The level of costs of medicines in the Russian Federation per capita is significantly lower than the corresponding levels in the developed countries. Conclusion. The drug provision of the population and healthcare institutions of the Russian Federation remains one of the most acute social problems affecting the nation's health, the possibility of active participation of people in employment and increase of the duration of their life. There are still some thorny issues relating the cost of medicines, the solvency of the population and the sizes of the budgets of the healthcare system.
Key words: нормативно-правовая база, льготное лекарственное обеспечение, нозология, legal and regulatory framework, subsidized medicines, nosology
MAIN STAGES OF FORMATION AND DEVELOPMENT OF STATE SANITARY AND EPIDEMIOLOGICAL SERVICE IN THE SMOLENSK REGION
Rogutskiy S.V., Sidorenkova L.M., Avchinnikov A.V., Avchinnikova S.O.
UDC: 614.255.3
Abstract: Objective. To study the main historical stages of the development of state sanitary and epidemiological service in the Smolensk region. Methods. The object of the study were historical documents describing the way of establishment of sanitary services on the territory of the Smolensk region beginning with the formation of the first institutions to a modern system of sanitary and epidemiological welfare and legislation to protect the rights of consumers. Results. It was established that the organization of the first sanitary institutions is associated with the name of a country doctor D.N. Zbankov, who worked in the Smolensk region in the late nineteenth century. A significant volume of preventive measures allows to believe that D.N. Zbankov the first sanitary inspector of the Smolensk region. In the years of revolution and civil war, the sanitary-epidemiological situation in the country was catastrophic, but in 1923, the epidemiological situation was stabilised, and a significant reduction in infectious morbidity was achieved. In the postwar period, various sanitary and epidemiological institutions of the region were unitied into a single structure - the Smolensk regional sanitary and epidemiological station. In 2004, the Federal Service for Supervision of Consumers’ Rights protection and Human Welfare was founded. Conclusion. The results of the research allowed to determine the main stages of formation and development of the state sanitary and epidemiological service in the Smolensk region.
Key words: санитарно-эпидемиологическая служба, история, Смоленская область, the sanitary-epidemiological service, history, Smolensk region
INSTITUTE OF PATHOLOGY AS AN OUTSTANDING FORM OF PATHOLOGICAL SERVICE ORGANIZATION IN SMOLENSK REGION
Dorosevich A.E., Dmitriev I.V.
UDC: 616-091(470.332)
Abstract: Objective. To investigate the working experience of a new organization form of pathological service “Smolensk Regional Insitute of Pathology” of Healthcare Department since 1994 till 2016. Methods. The data from annual reports of “Smolensk Regional Institute of Pathology” for the last 11 years were analyzed. A certain amount of autopsies and biopsies was calculated to analyze and assess the activity of pathological services according to standard documents. The staff was also analyzed. All the data were calculated and compared in dynamic. The value of all the data was assessed depending on several factors and reasons. The interaction between the factors and results of institution work was indicated. During the analysis, the data were grouped to characterize different aspects of pathological service. An assesssment of the activity of the institution in general, the influence of different factors on the results and the range of the relationship between indicators of activity was made. Results. This institution as a new organization form of pathological service was for the first time founded in Russia in 1994. The Institute of Pathology as a legal entity joined almost all pathological departments in the region, excluding pathological departments in non-state healthcare institutions. In the structure of the Institute of Pathology, function 7 interdistrict and 3 city departments of clinical pathology. In addition, there is a department of childhood clinical pathology, department of clinical pathology, infectious department, research laboratory, and expert -advisory department. Since 2005 to 2016 in the Institute of Pathology histological and surgical material from 615 219 patients were examined including 24 862 adult autopsies and 2315 children autopsies. Based on the results of postmortem examination in hospitals of Smolensk Region more than 4 000 mortality-morbidity conferences were organized. The Institute of Pathology provides a set of diagnostic and expert problems, as well as teaching work for their employees and health authorities and performs scientific work. At the end of 2016 the staff of the institution included 5 people having the degree of doctor of science and 11 candidates of medicine. Nowadays the Institute of Pathology provides the most objective information about the quality of work at all the levels of the health care system in Smolensk region, allowing to identify the ways for development of specific hospitals, and sometimes to choose a slightly different direction for health care development of the entire region. Conclusion. The centralized form of Pathological service organization is a progressive form and may be recommended for other regions of the Russian Federation.
Key words: патологоанатомическая служба, институт патологии, учреждение, Pathological service, Institute of Pathology, institution
FROM MIDWIVES TO OBSTETRIC SCIENCE: AN ANALYSIS OF THE OBSTETRIC LITERATURE PUBLISHED IN RUSSIA, 1760-1860
Mitsyuk N.A., Pushkareva N.L.
UDC: 618.2-07+396.6
Abstract: Objecive. The article examines the analysis of the obstetric literature in Russia from the 1760s (the time of the first work on obstetrics in the Russian language) to 1860 (the period of legitimation of gynecology as a separate medical discipline) to study the transition from folk (birth of art) obstetrics scientific. Methods. Relevant approaches were the approaches of social history of medicine, gender history, and the methods of content analysis, discourse analysis. Results. Until the early nineteenth century, textbook authors focused on the midwives. From the work of Maksimovic-Ambodik began the adoption of obstetrics as an independent scientific discipline and confrontation of scientific obstetrics the people, and as a result of doctors midwives. The authority of the science of obstetrics was established through the development of the doctrine of operative obstetrics. Obstetric operations, the use of new technological instruments, gynecological operations have become the benefits of clinicians. The adoption of social control of doctors over the sphere of procreation came from patologization of childbirth. Conclusion. The clinical space to the middle of the 19th century turned into the area of experiments with a female body which began to be considered as object of observations, and special the practician from physicians. The parturient woman from the active participant, the subject of patrimonial activity became passive subject to medical manipulations.
Key words: история родов, история акушерства, медикализация, повитухи, the history of childbirth, history of midwifery, the medicalization, midwives
IMPORTANCE OF MODERN GUIDES TO IMPROVE MONITORING AND TREATMENT OF ASTHMA IN CHILDREN (REVIEW)
Geppe N.A., Kolosova N.G.
UDC: 616.248-053.2: 681.31
Abstract: This review article presents an analysis of the current guidelines for bronchial asthma. Evaluation from the position of improving the monitoring and treatment of bronchial asthma in children is given in the article as well.
Key words: бронхиальная астма, дети, консенсус, Национальная программа, GINA, bronchial asthma, children, consensus, national program, GINA
SIGNIFICANCE OF RESPIRATORY SOUNDS IN PEDIATRICS (REVIEW)
Geppe N.A., Shatalina S.I., Malyshev V.S.
UDC: 616.233/.24-053.2-071.6
Abstract: The article presents an analysis (including historical) of the importance of respiratory sounds in the diagnosis of diseases of the respiratory system in children.
Key words: респираторные звуки, дети, диагностика, respiratory sounds, children, diagnostics
TНЕ APPLICATION POSSIBILITIES OF SMART IN ADOLESCENTS WITH ASTHMA
Denisova A.R.
UDC: 616.23+616.24
Abstract: Bronchial asthma (BA) is a chronic inflammatory disease of the Airways. Disease control involves reducing the frequency of exacerbations and frequency of hospitalizations or complete lack thereof, normalization of indicators of external respiration function on the background of properly selected basis (anti-inflammatory) therapy. Inhaled glucocorticosteroids (IGCs) have high clinical efficacy in children of all age groups due to anti-inflammatory activity, acting on the basis of the disease. This article focuses on the possibility of treating asthma with fixed-combination budesonide and formoterol used in the single inhaler - SMART technology.
Key words: бронхиальная астма, режим единого ингалятора (SMART), будесонид/формотерол, bronchial asthma, the single inhaler (SMART), budesonide/formoterol
STATE POLICY IN THE FIELD OF POPULATION-BASED PREVENTION OF CHILDHOOD OBESITY IN RUSSIA AND WORLD (REVIEW)
Kozlova L.V., Bekezin V.V., Peresetskaya O.V.
UDC: 616-03.053.1
Abstract: This review article presents an analysis of documents and recommendations adopted by the World Health Organization, and aimed at developing the key priority areas in the field of population-based prevention of childhood obesity in the world.
Key words: ожирение, дети, профилактика, ВОЗ, obesity, children, prevention, who
DIAGNOSIS AND TREATMENT OF NONSPECIFIC AORTOARTERITIS IN CHILDREN (REVIEW)
Lyskina G.A., Kostina Yu.O.
UDC: 616-1
Abstract: The article presents information on the literature data on the etiopathogenesis, diagnosis and treatment of nonspecific aortoarteritis in children.
Key words: aortoarteritis in children, clinic, diagnostics, treatment, аортоартериит у детей, клиника, диагностика, лечение
MONITORING CHILDREN RECEIVING ANTITHROMBOTIC THERAPY, IN THE OUTPATIENT DEPARTMENT (REVIEW)
Shpitonkov O.V., Podchernyaeva N.S., Lyskina G.A., Shira O.H., Kostina Y.O., Osminina M.K.
UDC: 616.831-005.1-085.27(083.131)
Abstract: Prevention of thrombotic complications in children requires long-term treatment in terms of ambulatornoi practices. Approaches to the treatment, characteristics of the main drugs used in children, methods of laboratory control are presented in the article.
Key words: тромбоз, тромбофилия, гепарин, антикоагулянты, антиагреганты, thrombosis, thrombophilia, heparin, anticoagulants, antiplatelet agents
PATIENT OSSIFICATION IN PEDIATRIC PRACTICE (CLINICAL CASE)
Golovanova N.Y., Rumyantsev V.A.
UDC: 616.612.112.1 053. 2
Abstract: The article touches upon the issues of genetic and pathogenetic features as well as diagnostics, differential diagnostics and treatment of rare genetic diseases, accompanied by the formation of ectopic ossification in connective-tissue formations in children of fibrodysplasia ossificans progressiva (FOP). Clinical observation of a patient with FOP diagnosis confirmed by the laboratory findings until the emergence of ossification is given in the article.
Key words: фибродисплазия оссифицирующая прогрессирующая, оссификаты, кальциноз, дети, fibrodysplasia ossificans progressiva, ossification, calcification, children